THE QUEST FOR SAFE-INJECTION SITES

Vancouver Centre Would Save Lives, Say Advocates. Focus is On Area Where
Scores of Women Vanished

VANCOUVER--Dean Wilson is fed up with burying his friends.

A veteran of the war with drugs that is the focal point of daily life on
Vancouver's downtown eastside, Wilson, 47, says he has lost hundreds of
pals over the years.

Many fell prey to overdoses in garbage-strewn alleys and filthy rooming
houses. In recent years, a slower-working but no less deadly scourge has
stalked them -- AIDS, hepatitis C and other killers that make their mark
through the end of a shared needle.

Now, Wilson, who has avoided the diseases if not the addictions during 25
years, is one of the leading advocates for opening so-called safe-injection
sites, a supervised environment that has helped save lives and reduce
dependency in Europe.

As president of the Vancouver Area Network of Drug Users, Wilson was part
of a group, led by newly elected Mayor Larry Campbell, who met Health
Canada officials in Ottawa last month to discuss guidelines for
establishing the first sites in North America.

They returned home planning to apply within weeks and open the doors this
spring.

But the sites are controversial: Some police, politicians and business
operators fear them, while numerous former drug users insist they will only
serve to foster addiction.

Supporters say they represent the difference between living and dying for
many users.

"We're trying to keep people healthy until they can make the decision to
quit," says Wilson, a heroin addict now in a methadone program. "It's not a
party down here.

"We're talking about people who are seriously ill and it's time we dealt
with them."

The downtown eastside, Vancouver's poorest neighbourhood, has been recently
thrust into the international spotlight with the investigation of 63
missing women -- predominantly drug addicts and prostitutes -- some of whom
disappeared as far back as the late 1970s.

Pig farmer Robert William Pickton, 53, is charged with first-degree murder
in connection with the deaths of 15 women. As the first evidence is to be
presented tomorrow in Pickton's preliminary hearing, it's clear an arrest
in the case has had little impact on the grim reality of daily life here.

In an alley, the picture of devastation underscores the need for action.
Amid the stench of urine and open metal garbage bins, a steady stream of
people crouch in doorways and behind telephone poles to shoot their heroin
or cocaine, oblivious to the lunchtime traffic on nearby East Hastings St.

One couple takes turns injecting each other. A man spends at least 15
minutes on all fours searching for drugs he's apparently dropped in the
gravel beside a wall.

A woman wanders over to a group of men and asks for "a rig," the street
name given to a syringe.

Into this scene walk two volunteers from a local agency. Both are clad in
fluorescent safety vests; one uses metal tongs, which he uses to pick up
discarded needles, while the other politely asks any of the drug users if
they need any more rigs.

Clutching one of the free syringes as he readies to inject a vial of liquid
cocaine, James Roy, 37, sums up his life since returning to drugs seven
years ago after a decade clean.

"The most important thing to me right now is my drugs," says Roy, who
describes himself as a father of three children who was once a successful
native craft wholesaler.

But when a safe-injection site is mentioned, he brightens. It would not
only be a warm, dry and clean place to go, it's also the type of spot where
a guy could get help if he overdosed, or guidance if he finally decided it
was time to try to quit again, he says.

"We really gotta get one," says Roy, whose girlfriend died of an overdose
two years ago.

After endorsing a safe-injection site, Roy slides the needle into a vein in
the crook of his right arm.

An estimated 1,200 addicts have died of drug overdoses in the past decade.

It is now the leading cause of death on the downtown eastside for men and
women aged 30 to 44.

Faced with those grim statistics -- and the spotlight that shone here with
the arrest last February of Pickton -- Campbell was swept into the mayor's
office in November largely on the strength of his promise to clean up the
neighbourhood.

Although his strategy embraces the so-called four pillars approach --
prevention, enforcement, treatment and harm reduction -- to the drug
problem, Campbell has focused his attention on safe-injection sites.

"We have to start treating these people like human beings who have an
illness and not like a criminal invading force," says Campbell, a former
coroner and the inspiration for the CBC-TV show Da Vinci's Inquest.

Last week, Campbell visited safe-injection sites in Switzerland, while on a
trip to deliver Vancouver's bid for the 2010 Winter Games to the
International Olympic Committee.

That country is one of the pioneers in the facilities and the mayor says he
wanted to see their operations firsthand.

A few dozen safe-injection sites now operate across Europe and in Sydney,
Australia.

The sites allow drug users to shoot up with sterile equipment in a clean
environment while medically trained staff are at the ready if needed.

The idea is to help prevent overdose deaths and transmission diseases as
well as steer addicts toward treatment programs.

Studies have shown the sites not only dramatically reduce the number of
overdose deaths and blood transmission diseases but are better at getting
people into treatment.

Facing increased drug overdose deaths and rising rates of HIV through the
1980s and early '90s, the German government shifted its focus to so-called
harm reduction.

One of the first safe-injection sites in the world opened in Frankfurt in
1994. Today, there are at least 15 operating across the country.

A recent report from the European Union says the approach has translated
into "a dramatic drop" in overdose deaths in Frankfurt and other cities

Other Canadian cities have expressed interest in the sites. Officials from
Victoria, Winnipeg, Montreal and Quebec city went to the meeting in Ottawa
last month, although everyone expects Vancouver to be the first to set up one.

In Toronto, the most recent statistics available from the office of the
chief coroner of Ontario point to an average of about 100 deaths by drugs
over the past 15 years.

But Ontario Health Minister Tony Clement says he was "appalled" by an
all-party committee of Parliament endorsing the sites in a report last month.

Citing British findings that the facilities were ineffective, he vowed to
fight them "every step of the way.

"If you want to do it in Vancouver, that's not for me to judge," Clement
told reporters. "If you want to do it in Montreal, that's not for me to judge.

"But if you want to do it in Toronto, I believe that I should have a say on
behalf of the people of Ontario and I don't think this is the right
solution," says Clement, urging the focus to be on more education,
awareness, treatment and rehabilitation.

Critics worry that the sites will condone and encourage drug use and serve
as a magnet to addicts.

"It's been marketed as a silver bullet but there is no such thing," says
John Turvey, executive director of the Downtown Eastside Youth Activities
Society in Vancouver, which began one of Canada's first needle exchange
programs in 1988 and doles out 3.5 million a year.

Turvey insists he does not oppose safe-injection sites.

But he wants to make sure they are part of an over-all "caring
infrastructure of services" that beefs up treatment and detox beds, mental
health services and social housing across the region.

The sites also raise constitutional and legal questions such as whether
minors are allowed, if police can force addicts to go there and how to best
combat dealers, Turvey says.

Dean Wilson is the first to recognize that safe-injection sites raise a
host of yet-to-be-answered questions, not the least of which is who will
actually pay for them.

He's also well aware that it's not the only solution and that all levels of
government will have to spend a lot more money on addiction services and
social programs to clean up the area.

But, he says, it's a good place to start.

Not only will the sites save lives and cut down on disease and health care
costs, he says, they are simply the right thing to do.